Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia

Byoung Seok Ye, Sang Won Seo, Jung Hyun Kim, Geon Ha Kim, Hanna Cho, Young Noh, Hee Jin Kim, Cindy W. Yoon, Sook Young Woo, Sook Hui Kim, Hee Kyung Park, Sung Tae Kim, Yearn Seong Choe, Kyung Han Lee, Jae Seung Kim, Seung Jun Oh, Changsoo Kim, Michael Weiner, Jae Hong Lee, Duk L. Na

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: To determine the independent and synergistic effects of amyloid and small vessel disease (SVD) burden on longitudinal cognitive decline in patients with subcortical vascular dementia (SVaD). Methods: A longitudinal cohort study was conducted involving patients from outpatient clinics of 2 tertiary referral centers. Sixty-one patients with SVaD were prospectively recruited and underwent MRI, 11C-Pittsburgh compound B (PiB) PET at baseline, and a 3-year annual neuropsychological follow-up. Effects of PiB positivity and SVD markers (white matter hyperintensities [WMH], lacunes, and microbleeds) on longitudinal cognitive decline were evaluated using generalized estimation equation after controlling for age, sex, education, APOE4 allele, and follow-up interval. Results: When individual neuropsychological tests were used as outcome measures, PiB positivity was associated with faster cognitive decline in attention, visuospatial, visual memory, and global cognition function. Higher WMH burden was associated with faster cognitive decline in attention, visuospatial, visual recognition memory, and semantic/phonemic fluency function, whereas lacunes and microbleeds had no significant effects. When global dementia rating (Clinical Dementia Rating sum of boxes) was considered as an outcome measure, however, only PiB positivity was associated with faster cognitive decline. Significant interactions between PiB positivity and higher SVD burden were found to affect cognitive decline in semantic word fluency (from WMH burden) and global dementia rating (from microbleed burden). Conclusions: In SVaD patients, amyloid burden, independently or interactively with SVD, contributed to longitudinal cognitive decline. Amyloid deposition was the strongest poor prognostic factor.

Original languageEnglish
Pages (from-to)1687-1693
Number of pages7
JournalNeurology
Volume85
Issue number19
DOIs
Publication statusPublished - 2015 Nov 10

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Vascular Dementia
Amyloid
Blood Vessels
Dementia
Semantics
Outcome Assessment (Health Care)
Sex Education
Neuropsychological Tests
Ambulatory Care Facilities
Cognitive Dysfunction
Tertiary Care Centers
Cognition
Longitudinal Studies
Cohort Studies
Alleles
2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole
White Matter

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Ye, B. S., Seo, S. W., Kim, J. H., Kim, G. H., Cho, H., Noh, Y., ... Na, D. L. (2015). Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia. Neurology, 85(19), 1687-1693. https://doi.org/10.1212/WNL.0000000000002097
Ye, Byoung Seok ; Seo, Sang Won ; Kim, Jung Hyun ; Kim, Geon Ha ; Cho, Hanna ; Noh, Young ; Kim, Hee Jin ; Yoon, Cindy W. ; Woo, Sook Young ; Kim, Sook Hui ; Park, Hee Kyung ; Kim, Sung Tae ; Choe, Yearn Seong ; Lee, Kyung Han ; Kim, Jae Seung ; Oh, Seung Jun ; Kim, Changsoo ; Weiner, Michael ; Lee, Jae Hong ; Na, Duk L. / Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia. In: Neurology. 2015 ; Vol. 85, No. 19. pp. 1687-1693.
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abstract = "Objective: To determine the independent and synergistic effects of amyloid and small vessel disease (SVD) burden on longitudinal cognitive decline in patients with subcortical vascular dementia (SVaD). Methods: A longitudinal cohort study was conducted involving patients from outpatient clinics of 2 tertiary referral centers. Sixty-one patients with SVaD were prospectively recruited and underwent MRI, 11C-Pittsburgh compound B (PiB) PET at baseline, and a 3-year annual neuropsychological follow-up. Effects of PiB positivity and SVD markers (white matter hyperintensities [WMH], lacunes, and microbleeds) on longitudinal cognitive decline were evaluated using generalized estimation equation after controlling for age, sex, education, APOE4 allele, and follow-up interval. Results: When individual neuropsychological tests were used as outcome measures, PiB positivity was associated with faster cognitive decline in attention, visuospatial, visual memory, and global cognition function. Higher WMH burden was associated with faster cognitive decline in attention, visuospatial, visual recognition memory, and semantic/phonemic fluency function, whereas lacunes and microbleeds had no significant effects. When global dementia rating (Clinical Dementia Rating sum of boxes) was considered as an outcome measure, however, only PiB positivity was associated with faster cognitive decline. Significant interactions between PiB positivity and higher SVD burden were found to affect cognitive decline in semantic word fluency (from WMH burden) and global dementia rating (from microbleed burden). Conclusions: In SVaD patients, amyloid burden, independently or interactively with SVD, contributed to longitudinal cognitive decline. Amyloid deposition was the strongest poor prognostic factor.",
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Ye, BS, Seo, SW, Kim, JH, Kim, GH, Cho, H, Noh, Y, Kim, HJ, Yoon, CW, Woo, SY, Kim, SH, Park, HK, Kim, ST, Choe, YS, Lee, KH, Kim, JS, Oh, SJ, Kim, C, Weiner, M, Lee, JH & Na, DL 2015, 'Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia', Neurology, vol. 85, no. 19, pp. 1687-1693. https://doi.org/10.1212/WNL.0000000000002097

Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia. / Ye, Byoung Seok; Seo, Sang Won; Kim, Jung Hyun; Kim, Geon Ha; Cho, Hanna; Noh, Young; Kim, Hee Jin; Yoon, Cindy W.; Woo, Sook Young; Kim, Sook Hui; Park, Hee Kyung; Kim, Sung Tae; Choe, Yearn Seong; Lee, Kyung Han; Kim, Jae Seung; Oh, Seung Jun; Kim, Changsoo; Weiner, Michael; Lee, Jae Hong; Na, Duk L.

In: Neurology, Vol. 85, No. 19, 10.11.2015, p. 1687-1693.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia

AU - Ye, Byoung Seok

AU - Seo, Sang Won

AU - Kim, Jung Hyun

AU - Kim, Geon Ha

AU - Cho, Hanna

AU - Noh, Young

AU - Kim, Hee Jin

AU - Yoon, Cindy W.

AU - Woo, Sook Young

AU - Kim, Sook Hui

AU - Park, Hee Kyung

AU - Kim, Sung Tae

AU - Choe, Yearn Seong

AU - Lee, Kyung Han

AU - Kim, Jae Seung

AU - Oh, Seung Jun

AU - Kim, Changsoo

AU - Weiner, Michael

AU - Lee, Jae Hong

AU - Na, Duk L.

PY - 2015/11/10

Y1 - 2015/11/10

N2 - Objective: To determine the independent and synergistic effects of amyloid and small vessel disease (SVD) burden on longitudinal cognitive decline in patients with subcortical vascular dementia (SVaD). Methods: A longitudinal cohort study was conducted involving patients from outpatient clinics of 2 tertiary referral centers. Sixty-one patients with SVaD were prospectively recruited and underwent MRI, 11C-Pittsburgh compound B (PiB) PET at baseline, and a 3-year annual neuropsychological follow-up. Effects of PiB positivity and SVD markers (white matter hyperintensities [WMH], lacunes, and microbleeds) on longitudinal cognitive decline were evaluated using generalized estimation equation after controlling for age, sex, education, APOE4 allele, and follow-up interval. Results: When individual neuropsychological tests were used as outcome measures, PiB positivity was associated with faster cognitive decline in attention, visuospatial, visual memory, and global cognition function. Higher WMH burden was associated with faster cognitive decline in attention, visuospatial, visual recognition memory, and semantic/phonemic fluency function, whereas lacunes and microbleeds had no significant effects. When global dementia rating (Clinical Dementia Rating sum of boxes) was considered as an outcome measure, however, only PiB positivity was associated with faster cognitive decline. Significant interactions between PiB positivity and higher SVD burden were found to affect cognitive decline in semantic word fluency (from WMH burden) and global dementia rating (from microbleed burden). Conclusions: In SVaD patients, amyloid burden, independently or interactively with SVD, contributed to longitudinal cognitive decline. Amyloid deposition was the strongest poor prognostic factor.

AB - Objective: To determine the independent and synergistic effects of amyloid and small vessel disease (SVD) burden on longitudinal cognitive decline in patients with subcortical vascular dementia (SVaD). Methods: A longitudinal cohort study was conducted involving patients from outpatient clinics of 2 tertiary referral centers. Sixty-one patients with SVaD were prospectively recruited and underwent MRI, 11C-Pittsburgh compound B (PiB) PET at baseline, and a 3-year annual neuropsychological follow-up. Effects of PiB positivity and SVD markers (white matter hyperintensities [WMH], lacunes, and microbleeds) on longitudinal cognitive decline were evaluated using generalized estimation equation after controlling for age, sex, education, APOE4 allele, and follow-up interval. Results: When individual neuropsychological tests were used as outcome measures, PiB positivity was associated with faster cognitive decline in attention, visuospatial, visual memory, and global cognition function. Higher WMH burden was associated with faster cognitive decline in attention, visuospatial, visual recognition memory, and semantic/phonemic fluency function, whereas lacunes and microbleeds had no significant effects. When global dementia rating (Clinical Dementia Rating sum of boxes) was considered as an outcome measure, however, only PiB positivity was associated with faster cognitive decline. Significant interactions between PiB positivity and higher SVD burden were found to affect cognitive decline in semantic word fluency (from WMH burden) and global dementia rating (from microbleed burden). Conclusions: In SVaD patients, amyloid burden, independently or interactively with SVD, contributed to longitudinal cognitive decline. Amyloid deposition was the strongest poor prognostic factor.

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